| NPI | 1588911754 |
|---|---|
| Former Name | THERESA MARY ANN ROY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225800000X Recreation Therapist (Licence: CA 41502) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA 41502) |
| 171W00000X Contractor (Licence: CA 41502) | |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2015-05-01 |